JENNY DIAL, Copyright 2010 Houston Chronicle |
October 20, 2010

Additions to the protocol include a rule that a student-athlete sustaining a concussion will not be allowed to return to play on the same day.

Since the University Interscholastic League began addressing player concussions in 2004, coaches and trainers throughout Texas have wrestled with one main issue: how to diagnose a player who has suffered a brain injury.

On Monday, the UIL made more changes to its "concussion management protocol," and while schools are happy to adopt and implement the new rules, officials still struggle with the original problem.

"The new protocols are good protocols. They are simple and easy to follow," Katy head athletic trainer Justin Landers said. "But the hard part is still making the call on what a concussion is and whether a player needs to be out for a long period of time."

The new additions to the protocol, which follow those of the National Federation of State High School Associations, include a rule that a student-athlete will not be allowed to return to action on the same day he suffers a suspected concussion. Under current rules, a player can return after 15 minutes if there are no symptoms of a concussion. The new rules will go into effect Aug. 1, 2011, after they are approved by the state's Commissioner of Education.

Tekyl said he and his staff rely on an on-site doctor or trainer to determine the extent to which a player is hurt.

"I am not a doctor," Tekyl said. "I will not try to figure out if a player has a concussion or not. I leave that to the pros."

Because there is no clear diagnosis on most concussions, even the pros can make the wrong call. There are warning signs, however, the most obvious being loss of consciousness. Others include vomiting and nausea, dizziness, headaches, slurred speech and confusion.

"I have had kids with no symptoms at all that ended up having headaches later," Landers said. "I have had kids show symptoms and turn out to be perfectly fine. The protocol is good to have, but it is always going to be hard to make that call."

One thing area high schools are using to help determine the severity of head injuries is baseline testing, a term for any testing used prior to a treatment or activity. One of the more popular baseline tests for concussions is "ImPACT Testing," which was developed more than a decade ago in Pittsburgh. About 70 area schools use the program, because it is inexpensive and accessible and has been effective in the NFL and NHL.

Cale Cosper, an athletic trainer for Richmond Bone and Joint Clinic, said the process is easy. Athletes can take the test prior to their season through the clinic's website and receive results. Then, when a player suffers any kind of head injury on the field or court, the athletic trainers on the sidelines will be better equipped to know if that player's brain activity has been affected.

"Everyone's brain is different," Cosper said. "That is why this is a good test. It measures everyone differently and can be really helpful in determining how a person's head is affected, and it helps us decide how long it takes to get someone back on the field."

The UIL hasn't made baseline testing mandatory yet, but policy director Mark Cousins said the league is for anything that aids the safety of players.

"It is another tool in the toolbox," Cousins said. "We are happy to see that concussion management is becoming a really big priority."

It isn't just a priority for schools. Area physicians are getting involved, volunteering to attend games each week for schools that don't have a doctor on staff. Tekyl said Dr. Walter Lowe, who serves as head team physician for the Texans, Rockets and University of Houston, has been instrumental in making sure area schools have a doctor on hand at each game. Most of these doctors, Tekyl said, are there for free.

Meanwhile, medical professionals will continue to learn about brain injuries. They're not an exact science yet, but Cosper said the best policy is to take them seriously.

"Any blow to the head could be a concussion, and it if isn't diagnosed, the next concussion could be worse," Cosper said. "It isn't always about getting a player back in a game quickly. It is about getting him back in safely."